Is It Possible to Predict Sepsis, the Most Serious Complication in Prostate Biopsy?

Abstract

Objective: Prostate biopsy for the diagnosis of prostate cancer by transrectal ultrasonography (TRUS) is a common procedure used in daily urology practice with a low complication rate and easy applicability. In this study, the precipitating factors and prophylaxis for sepsis, the worst complication of the procedure, were assessed. Patients and Methods: 2,023 patients with suspected prostate cancer who underwent biopsy by TRUS in one center were assessed retrospectively. The relationship between sepsis and age, serum total prostate-specific antigen (PSA) level, PSA density, prostate volume, number of biopsies, number of repeated biopsies, accompanying diagnosis of prostatitis, presence of urethral catheter, and presence of diabetes mellitus was assessed. Data were analyzed using the t test and logistic regression analysis. Results: Of the 2,023 patients, 62 (3.06%) developed sepsis within 5 days after biopsy. There was no significant relationship between the biopsy and the above parameters using the logistic regression analysis. Using the t test, it was found that the number of biopsy cores (p < 0.001), presence of urethral catheter (p < 0.0001), and presence of diabetes mellitus (p < 0.0001) were predictive factors for sepsis. Conclusion: Sepsis is a rare but life-threatening complication after prostate biopsy by TRUS. Although preoperative prophylactic oral antibiotics and enema before biopsy have proven to be effective in decreasing urinary tract infection rates, patients with urethral catheter, diabetes mellitus or those to undergo biopsy from more sites than ten cores should be closely monitored after biopsy.

Incidence of infectious complications following transrectal ultrasound-guided prostate biopsy in Calgary, Alberta, Canada: A retrospective population-based analysis

“…22 Patient-specific risk factors for FQ resistance include increasing age, comorbidities, international travel, recent hospitalization, prior FQ exposure and urinary catheterization. 1,3,23,24 The aim of our study was to characterize the prescribing patterns of prophylactic antibiotics prior to TRUS-PB in a large urban centre. We also investigate the relationship between increasing E. coli resistance rates and the incidence of infectious complications following prostate biopsy.…”

Clinical importance of the antibiotic regimen in transrectal ultrasound-guided biopsy: quinolone versus cephalosporin

“…Some controversy remains regarding the association between infection-related complications after prostate biopsy and procedure-related risk factors such as number of biopsy cores [6–8, 25]. Our study demonstrated that the number of biopsy cores was not associated with infection-related hospitalization after TRUS-PBx.…”

Impact of Rectal Swabs on Infectious Complications after Transrectal Prostate Biopsy

“…However, their frequency varies considerably. Simsir et al [11] reported a rate of sepsis of 3.06% in a sample of 2,023 patients in Turkey. De Jesus et al [12] reported a 14.4% rate of post-PB IC consisting of 1.7% sepsis, 9.2% UTI, 0.6% orchitis, and 0.6% prostatitis.…”